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Transposition of the great arteries is a congenital heart defect caused when a child’s heart develops incorrectly in the womb. This condition occurs when the heart’s two most important blood vessels—the aorta and the pulmonary artery—are reversed.
In a healthy heart, the aorta pumps oxygen-rich blood to the body, and the pulmonary artery sends blood to the lungs (where the blood absorbs oxygen so that the oxygen-rich blood can then be pumped to the body). With this condition, not enough oxygen-rich blood circulates from the lungs to the body.
Transposition of the great arteries in infants is usually diagnosed shortly after birth, but some may have been diagnosed by fetal ultrasounds before birth. Babies with the condition often have a blue tint to their skin, a sign of cyanosis because oxygen-rich blood has no way to get to the body.
The most common form of transposition
Most infants with D-type transposition will have symptoms and be diagnosed shortly after birth. In this congenital abnormality, no oxygen-rich blood goes to the body and:
Children with transposition of the great arteries are usually diagnosed within a few weeks of birth.
The most common symptom is cyanosis, which is a blue tint to the skin that is caused when not enough oxygen gets to a child’s body.
Transposition of the great arteries is a very rare congenital heart defect. Boys are more susceptible to D-type transposition, although the reason is not known. Children with a family history of transposition are more likely to develop the condition.
If your doctor suspects your child has a transposition of the great arteries, he or she will order further tests. These will help a cardiologist identify the condition and evaluate its severity.
Common tests include:
To learn more about transposition of the great arteries, visit The American Heart Association.
At Children’s Colorado, our pediatric cardiologists and heart surgeons begin treating transposition of the great arteries right after birth.
If your child is born with D-type transposition, he or she may require medication and surgery very soon after birth. Most often, children are treated in the intensive care unit with intravenous (IV) medication and oxygen. Sometimes a breathing tube may be necessary for a short time.
If the hole between the atria (atrial septal defect) is not large enough, a minor procedure called an atrial septectomy or “Rashkind” procedure may be necessary to widen it so oxygen-rich and oxygen-poor blood can mix inside the heart. This is usually performed in the intensive care unit by your child’s cardiologist.
The only treatment for D-type transposition of the great arteries is heart surgery. The best and most common surgery is the arterial switch procedure, which is performed by pediatric cardiac surgeons. During this surgery, the pulmonary artery and aorta are switched back to their normal positions and the coronary arteries are also switched along with the large blood vessels. Any holes in the heart will also be repaired.
After surgery, most children with transposition of the great arteries go on to live normal, healthy lives, but should be followed by a cardiologist for some time after surgery.
Cardiology - Pediatric, Pediatrics
Certified Pediatric Nurse Practitioner, Certified Family Nurse Practitioner, Certified Pediatric Clinical Nurse Specialist